During the lifetime of a patient, it may be necessary to perform a joint replacement procedure on the patient as a result of, for example, disease or trauma. Such a joint replacement procedure may involve the use of a prosthetic component or prosthesis to replace a portion of the patient's natural bone. Heretofore designed prosthesis are generally constructed of a metallic or composite material. A problem arises when such metal or composite prosthesis are utilized to replace a relatively large portion of a bone. In particular, if a large portion of a patient's natural bone must be replaced with a prosthesis, it is generally difficult to attach the soft tissue required for joint operation (e.g. ligaments and tendons) to the implanted prosthesis. For example, as a result of cancer or other type of disease, the entire proximal end portion of a patient's tibia may have to be removed and replaced with a tibial prosthesis. In such a case, the natural point of connection for the distal end portion of the patient's patellar ligament (i.e. the tibial tuberosity) is also removed. Hence, the distal end portion of the patient's patellar ligament must then be secured to the tibial prosthesis in order to provide for functional operation of the patient's knee.
A number of approaches have heretofore been taken in an attempt to attach soft tissue such as ligaments and tendons to a metal or composite prosthesis. The most common approach has been to configure the prosthesis with a number of suture holes to which the soft tissue (e.g. a ligament or tendon) may be sutured. One problem with this approach is that the soft tissue has no source of nourishment. Moreover, such a configuration of the prosthesis does not provide adequate surface features or the like for facilitating ingrowth or anchoring of the soft tissue to the prosthesis.
Another approach which has been utilized involves the use of an allograft or composite allograft prosthesis in lieu of a metal or composite prosthesis. Such prosthesis are generally harvested from a donor upon death thereof and then frozen until needed. However, the availability of allograft prostheses is becoming more and more scarce. Moreover, even when available, such harvested allograft prostheses often times do not possess the requisite number of tissue attachment sites. In addition, patients requiring the joint replacement procedure are sometimes either very large or very small in size which can make the procurement of a properly sized allograft prosthesis very difficult.
Yet another approach which has been utilized involves the use of bone plugs and grafts which are threaded into or otherwise secured to the prosthesis. However, this approach suffers from many of the same drawbacks as does the use of an allograft prosthesis. Moreover, since bone plugs are constructed of dead tissue, they tend to become brittle over time and eventually break down under heavy loads.
What is needed therefore is an apparatus and method for securing soft tissue to a prosthesis which overcomes one or more of the above-mentioned drawbacks. What is particularly needed is an apparatus and method for securing soft tissue to a prosthesis which provides enhanced mechanical anchoring of the soft tissue while also stimulating or otherwise facilitating tissue ingrowth.